Is Your Heart Making You Anxious?

“What’s good for the mind also tends to be good for the heart.”

If you have had any heart issues, have you also had anxiety, particularly about being active with/after heart issues?

The American Heart Association says, “After any illness, it’s normal to feel afraid and unsure of the future. You may be scared because you don’t know what lies ahead, or because you feel less control over your life. Every heart patient has some degree of fear, but if your fear is overwhelming, it can prevent you from getting well and staying well.”

Additionally, the National Center for Biotechnology Information in a report on a clinical trial study noted, “Anxiety is highly prevalent among patients with coronary heart disease (CHD), and there is growing evidence that high levels of anxiety are associated with worse prognosis. However, few studies have evaluated the efficacy of treating anxiety in CHD patients for reducing symptoms and improving clinical outcomes. Exercise and selective serotonin reuptake inhibitors have been shown to be effective in treating patients with depression, but have not been studied in cardiac patients with high anxiety.” They go on to state, “There is growing evidence that exercise may have beneficial effects on anxiety. Epidemiological studies have observed an inverse relationship between exercise and anxiety.”

And another study, this one by Jean-Christophe Chauvet-Gelinier, MD, PhD, and Bernard Bonin, MD, reported in Science Direct from the Annals of Physical and Rehabilitation Medicine, offers “For rehabilitation to be effective in heart disease patients, they need to have a rather good psychological status.” And the Psychiatric Times underscores that “catch 22” with “Women and men with heart disease who perceive themselves as disabled and unable to perform their usual activities are three times more likely to report anxiety (Nickel et al., 1990). In a one-year prospective study of individuals with heart disease, Sullivan and colleagues (1997) explored associations of anxiety with self-reported physical function and activity interference. Findings indicated that those who report higher levels of anxiety also report higher levels of physical disability. High levels of anxiety affect functional status after heart surgery as well. In a randomized clinical trial with 156 participants, greater perceived tension/anxiety level at four weeks predicted decreased self-reported activity for both men and women (Ruiz et al., 1992). Relationships between anxiety and quality of life have also been empirically examined. Anxiety related to decreased functional ability after myocardial infarction has been found to substantially reduce quality of life among survivors and their families.”

Una McCann, M.D. is a psychiatrist and directs the Anxiety Disorders program at Johns Hopkins Medicine. She compares the reaction to a sudden heart attack as being like post-traumatic stress disorder:

• You’re likely to be shocked by your near-death experience and extremely hesitant to do the things you used to do. • You might constantly relive the life-threatening event, and avoid the activity or place associated with the heart attack. • Recurring anxious thoughts may impede your ability to get regular sleep. • Your thoughts about what lies ahead may be extremely negative and cause a drastically foreshortened outlook of the future

She goes on to address anxiety management by saying, “The goal is to keep the patient from placing too much concentration on anxieties about the future that are impossible to control, and help the patient focus on the present. Anxiety management may encompass relaxation exercises, sensory focusing, and yoga techniques.”

Most heart patients are advised to exercise and be physically active because exercise can make the heart muscle stronger. The Cleveland Clinic, a nonprofit multispecialty academic medical center, in their guide to the overall benefits of exercise for patients with heart failure suggest a combination of flexibility, cardiovascular/aerobic, and strength training. In their commentary on flexibility, they note, “This type of exercise involves slow movement to lengthen the muscles. Flexibility exercises include stretching, tai chi and yoga. They are also used before and after exercising to prevent injury and strain. Benefits include better balance, range of motion and better movement in your joints.”

There can be a large gap between being advised to be active and feeling confident enough in your health to actually become active. A heart patient may submit to cardiac rehabilitation because it is prescribed/mandated by the physician and occurs in a health services environment. But what happens after cardiac rehab ends? If any anxiety about physical ability exists, what options can a heart patient pursue for exercise and physical activity?

Before beginning any exercise program, please consult your physician, whether you are a heart patient or not. If your physician clears you to begin activity, we have a suggestion for you! There are many activities you could pursue, but, at Sunrise Yoga, we have a class geared specifically to with an existing heart condition and for those who are seeking increased heart wellness!

This class, held on Wednesdays from 11:30 am to 12:30 pm, is a gentle yoga class led by Valerie Kiser, owner and director of Sunrise Yoga and a certified instructor for Cardiac Yoga® (Cardiac Yoga® is a registered trademark of M. Mala Cunningham , Ph.D. and is used with exclusive permission.).

With Valerie at your side, you will practice yoga poses, breathing techniques, as well as mindfulness and relaxation. All of these activities are supported by information from the American Heart Association, and Harvard Health Publishing says, “What’s good for the mind also tends to be good for the heart.”

They continue, “The mind-calming practice of meditation may play a role in reducing your risk of heart disease, according to a scientific statement published in the Sept. 28, 2017, Journal of the American Heart Association. Experts reviewed dozens of studies published over the past two decades and found that meditation may improve a host of factors linked with heart disease — making it worth including in an overall program for ongoing heart care.”

Let Valerie guide you into a healthier heart, healthier you! Start with Cardiac Yoga® and, if you want more, Valerie can assist you in finding other Sunrise Yoga classes to suit your needs.